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Another half-baked piece of legislation has come into force today - if you die it is presumed that you were willing for your organs to be harvested immediately. Theoretically you can opt out, and likewise your relatives can overrule your wishes regardless of whether you actively or passively opted out. Apparently this will save many lives due to there currently being a shortage of donors for the transplant list, particularly amongst the BAME community.

How long will it last before public opinion swings against this and it is hastily dropped?

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Another half-baked piece of legislation has come into force today - if you die it is presumed that you were willing for your organs to be harvested immediately. Theoretically you can opt out, and likewise your relatives can overrule your wishes regardless of whether you actively or passively opted out. Apparently this will save many lives due to there currently being a shortage of donors for the transplant list, particularly amongst the BAME community.

How long will it last before public opinion swings against this and it is hastily dropped?

"We often co-opt our prefrontal cortex to rationalise choices that were actually driven by our emotions"
“What am I not seeing?" ...“What else is true?” ... “What is my responsibility in this situation?”

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I actually never volunteered as a donor because many years ago I saw an Horizon about transplants and they looked at several countries. In most there were specific and clear tests to make sure you were actually dead before cannibalising you for parts.
The UK offering was a BMA spokesman who bumbled a lot and couldn't offer any reassurance that anyone in the UK (like a junior doctor on hour 89 of his week) would actually check carefully you were a goner.

I decided to wait until better assurances were available, but they never appeared on my radar. Now they just tell us it will happen anyway - but I've still not seen anything to say how they check.

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I actually never volunteered as a donor because many years ago I saw an Horizon about transplants and they looked at several countries. In most there were specific and clear tests to make sure you were actually dead before cannibalising you for parts.
The UK offering was a BMA spokesman who bumbled a lot and couldn't offer any reassurance that anyone in the UK (like a junior doctor on hour 89 of his week) would actually check carefully you were a goner.

I decided to wait until better assurances were available, but they never appeared on my radar. Now they just tell us it will happen anyway - but I've still not seen anything to say how they check.

Depends if you’re heading towards donating after cardiac death, or after brain death.

The former includes checking for an absence of heart sounds, palpable pulse, respiratory effort, breath sounds, pupillary reaction to light, and reaction to a painful stimulus. You can also use any monitors that might have been in situ at time of death (ECG and blood pressure monitors).

Brain death testing is much more involved, and essentially targets reflexes from the majority of the cranial nerves that originate in the brainstem.

Given the complicated and involved nature of organ donation, most deceased donors have to die in an intensive care unit for it to happen. Which means high staffing levels and close supervision of juniors.

I'm not crazy, the attack has begun.

Another half-baked piece of legislation has come into force today - if you die it is presumed that you were willing for your organs to be harvested immediately. Theoretically you can opt out, and likewise your relatives can overrule your wishes regardless of whether you actively or passively opted out. Apparently this will save many lives due to there currently being a shortage of donors for the transplant list, particularly amongst the BAME community.

How long will it last before public opinion swings against this and it is hastily dropped?

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About time too.
Not a fan of volunteering, but if it can save more lives, especially for the young 'uns, then it's a good thing.
I've always carried a donor card, although never in the hope that it would be needed

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The UK offering was a BMA spokesman who bumbled a lot and couldn't offer any reassurance that anyone in the UK (like a junior doctor on hour 89 of his week) would actually check carefully you were a goner.

I would be surprised if the NHS had relevant regulation, an ability to enforce accountability, or oversight of possible fraud.

When my father was in ICU (years ago) the lead consultant made a clinical decision to withdraw treatment with DNR on the basis he had, with no witnesses, inflicted on my father sufficient pain to be sure there was no response.

I complained, naturally, and then went to the bed. I showed the nurse how to get a response without inflicting pain, and was too late because the consultant had left the building - the nurses had no power to override a doctor's decision. The nurse went ahead and switched off the treatment after witnessing a response - like a gentle but fanatical military guard.

The only thing that had changed from one day to the next, as far as I can gather, is that the NHS had obtained without witnesses my father's signature for the DNR and probably more - presumably just before he became (subjectively) unresponsive?!

I cannot accept an organised hierarchy following orders can be defended as overworked or poorly trained. This is one of many bad experiences that informs my overall opinion of the NHS.

"We often co-opt our prefrontal cortex to rationalise choices that were actually driven by our emotions"
“What am I not seeing?" ...“What else is true?” ... “What is my responsibility in this situation?”

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I wouldn't say that, but I think the old fashioned "Doctor knows best - you mustn't question his godlike abilities" attitude is taking a long time to grow out. Too many are still dictators rather than leaders.

"We often co-opt our prefrontal cortex to rationalise choices that were actually driven by our emotions"
“What am I not seeing?" ...“What else is true?” ... “What is my responsibility in this situation?”

"We often co-opt our prefrontal cortex to rationalise choices that were actually driven by our emotions"
“What am I not seeing?" ...“What else is true?” ... “What is my responsibility in this situation?”

I'm not crazy, the attack has begun.

I would be surprised if the NHS had relevant regulation, an ability to enforce accountability, or oversight of possible fraud.

When my father was in ICU (years ago) the lead consultant made a clinical decision to withdraw treatment with DNR on the basis he had, with no witnesses, inflicted on my father sufficient pain to be sure there was no response.

I complained, naturally, and then went to the bed. I showed the nurse how to get a response without inflicting pain, and was too late because the consultant had left the building - the nurses had no power to override a doctor's decision. The nurse went ahead and switched off the treatment after witnessing a response - like a gentle but fanatical military guard.

The only thing that had changed from one day to the next, as far as I can gather, is that the NHS had obtained without witnesses my father's signature for the DNR and probably more - presumably just before he became (subjectively) unresponsive?!

I cannot accept an organised hierarchy following orders can be defended as overworked or poorly trained. This is one of many bad experiences that informs my overall opinion of the NHS.

There is an arrogance to a lot of the young people that go to train to be Doctors, possibly because they are told that they are the elite within the education system.
I find it hard to distinguish between my dislike of the NHS as an organisation and my respect for the hard work that many within it put in both consistently before and now during the current situation. Having worked on the fringes (IT) and seen the appalling treatment given to my and my Wife's parents I can only see it as a grossly inefficient and unfair system. The lack of joined up thinking and responsibility for people released to the care system, again both before and during the current situation, is untenable and why I feel justified in referring to the whole thing as a Ponzi scheme. However, because the NHS was created in the post WW2 optimism it has become a political totem that cannot be questioned. Perhaps after this crisis we will address the twin issues of the NHS and Social Care and come to an affordable joined up solution.
As an aside, it is notable how in the normally much vaunted Sweden with its high tax and welfare model they are failing to prolong the lives of their care home residents - perhaps the Swedish care pathway will become as discredited as the Liverpool version.

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